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Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 12,602 $ 11,529 $ 25,119 $ 22,952
Revenues ratio from third party payers 100.00% 100.00% 100.00% 100.00%
Medicare [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 2,635 $ 2,425 $ 5,405 $ 4,949
Revenues from third party payers, Ratio 20.90% 21.00% 21.50% 21.60%
Managed Medicare [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 1,595 $ 1,345 $ 3,184 $ 2,744
Revenues from third party payers, Ratio 12.70% 11.70% 12.70% 12.00%
Medicaid [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 416 $ 357 $ 763 $ 638
Revenues from third party payers, Ratio 3.30% 3.10% 3.00% 2.80%
Managed Medicaid [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 554 $ 586 $ 1,167 $ 1,147
Revenues from third party payers, Ratio 4.40% 5.10% 4.60% 5.00%
Managed Care and Other Insurers [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 6,425 $ 5,993 $ 12,851 $ 12,055
Revenues from third party payers, Ratio 50.90% 51.90% 51.10% 52.50%
International (Managed Care and Other Insurers) [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 284 $ 295 $ 581 $ 600
Revenues from third party payers, Ratio 2.30% 2.60% 2.30% 2.60%
Product and Service, Other [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 693 $ 528 $ 1,168 $ 819
Other, Ratio 5.50% 4.60% 4.80% 3.50%